Wavefront interactive refraction display

ABSTRACT

Embodiments of this invention generally relate to systems and methods for wavefront interactive refraction display and more particularly to systems and methods for capturing and displaying eye wavefront interactive refraction data based on the desired refractive state of the patient&#39;s eye.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a continuation of and claims priority to U.S. patentapplication Ser. No. 14/199,702, filed Mar. 6, 2014, which claimspriority to U.S. Provisional Application No. 61/799,764, filed on Mar.15, 2013, the entire contents of which are incorporated herein byreference.

FIELD OF THE INVENTION

Embodiments of the present invention generally relate to wavefrontinteractive refraction display and more particularly to systems andmethods that capture and display eye wavefront interactive refractiondata.

BACKGROUND OF THE INVENTION

Refractive measurements of the eye should occur with the accommodationof the eye fully relaxed. To accomplish this, aberrometers move aninternal visual target to draw the eye to its farthest focus. Then afinal refractive measurement is made. When the target is at the optimalposition, the target is “fogged” and it always appears slightly fuzzy tothe patient. However, sometimes the eye does not respond to the target,and the final refractive measurement can occur with the eye partiallyaccommodated. When this happens, the patient is said to exhibit“instrument myopia” and the target may either appear clear or fuzzy tothe patient.

While most people respond reliably to the target inside an aberrometer,some patients persistently exhibit instrument myopia. Repeatedmeasurements can fatigue the eye and the patient can exhibit increasinginstrument myopia.

When patients are screened for LASIK treatment, they are measured bothwith a manifest refraction and with an aberrometer. Typically themanifest refraction is done first, and then the results are entered intothe aberrometer software. If the wavefront and manifest refractionsagree within some tolerance, the patient may be treated with wavefrontguided LASIK. However, if the measurements disagree, the patient canonly be treated with standard LASIK, based on the manifest refractionalone.

To ensure the greatest number of patients qualify for wavefront guidedLASIK, the aberrometer should minimize instrument myopia, or providesome means to help the doctor to get the patient to relax theiraccommodation.

Doctors have a number of techniques they can use to coax a patient intorelaxing accommodation. For instance, they can distract a patient bytelling them to grip a handle, or mentally subtract two numbers.However, when the doctor employs such a technique, a standardmeasurement follows without any interactive feedback. Consequently thedoctor has to wait many seconds to see if the desired effect occurred.If the effect of the coaxing was transitory, the software will stillproduce a measurement with instrument myopia. Also, coaxing takes time.Prolonged measurement sessions tend to fatigue the eye and often resultsin the patient showing increasing instrument myopia.

SUMMARY OF THE INVENTION

The field of the invention relates to systems and methods for wavefrontinteractive refraction display and more particularly to systems andmethods that capture and display eye wavefront interactive refractiondata. In an embodiment, a method for identifying a time for capturingeye refraction data includes sensing a waveform of light passing througha patient's eye over a period of time, wherein the waveform is affectedby an optical property of the patient's eye, calculating the refractivestate of the patient's eye with the sensed waveform, displaying anindication of the current refractive state of the patient's eye,receiving a command to capture eye refraction data when the desiredrefractive state of the patient's eye is reached, and capturing eyerefraction data.

Further areas of applicability of the present disclosure will becomeapparent from the detailed description provided hereinafter. It shouldbe understood that the detailed description and specific examples, whileindicating various embodiments, are intended for purposes ofillustration only and are not intended to necessarily limit the scope ofthe disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure is described in conjunction with the appendedfigures:

FIG. 1 is a schematic illustration of one embodiment of a wavefrontinteractive refraction system;

FIG. 2 is a schematic illustration of one embodiment of a wavefrontinteractive refractor;

FIG. 3 is a schematic illustration of one embodiment of the patientinterface of the wavefront interactive refractor;

FIG. 4 is a schematic illustration of one embodiment of the userinterface of the wavefront interactive refractor;

FIGS. 5A-5D depict embodiments of the graphic display of a refractivestate of an eye;

FIG. 6 is a flowchart illustrating one embodiment of a process foridentifying a time for capturing the refractive state of an eye;

FIG. 7 is a flowchart illustrating another embodiment of a process foridentifying a time for capturing the refractive state of an eye;

FIG. 8 is a flowchart illustrating one embodiment of a process foridentifying a patient task resulting in a desired refractive state of aneye;

FIG. 9 is a list of exemplary tasks that can be performed in connectionwith the wavefront interactive refractor; and

FIG. 10 is a list of exemplary changes to a target that can be made toaffect a change in the refractive state of the patient's eye.

In the appended figures, similar components and/or features may have thesame reference label. Where the reference label is used in thespecification, the description is applicable to any one of the similarcomponents having the same reference label. Further, various componentsof the same type may be distinguished by following the reference labelby a dash and a second label that distinguishes among the similarcomponents. If only the first reference label is used in thespecification, the description is applicable to any one of the similarcomponents having the same first reference label irrespective of thesecond reference label.

DETAILED DESCRIPTION OF THE INVENTION

The ensuing description provides preferred exemplary embodiment(s) only,and is not intended to limit the scope, applicability or configurationof the disclosure. Rather, the ensuing description of the preferredexemplary embodiment(s) will provide those skilled in the art with anenabling description for implementing a preferred exemplary embodiment.It is understood that various changes may be made in the function andarrangement of elements without departing from the spirit and scope asset forth in the appended claims.

Wavefronts

A wavefront can be used to describe a wave including, for example, anelectromagnetic wave. A wavefront is the locus of points having the samephase, and can be a line or curve in two dimensions, or surface of awave that is propagating in three dimensions. Wavefront measurements canbe used to evaluate the quality of an optical system and/or to identifyimperfections in an optical system. In some embodiments, thesemeasurements can be performed by a wavefront sensor which is a devicethat can measure wavefront aberration in a coherent signal. AHartmann-Shack system is one embodiment of a wavefront sensor.

With reference now to FIG. 1, schematic illustration of one embodimentof a wavefront interactive refraction system 100 is shown. The wavefrontinteractive refraction system 100 can capture data relating to one orseveral refractive states the patient's eye, and can come in someembodiments be configured to provide information to a user to identify atime at which the refractive state of the patient's eye should becaptured, and to capture data corresponding to a desired refractivestate of the patient's eye. In some embodiments, information relating tothe captured refractive state of the patient eye can be used fordetermining corrective treatments for the eye, including, for example,determining an appropriate corrective lens and/or an appropriatecorrective surgery.

Wavefront interactive refraction display 100 includes an eye 102. Theeye 102 can be any eye, and can be, for example, a human eye. The eye102 includes the cornea 104, the lens 106, the retina 108, and the opticnerve 110.

Wavefront interactive refraction display 100 includes a wavefrontinteractive refractor 112. Wavefront interactive refractor 112 can beconfigured to generate data identifying a refractive state of the eye102. In some embodiments, the wavefront interactive refractor 112 cangenerate data identifying a refractive state of the eye 102 by sensing awavefront passing through the eye 102 either towards or away from theretina 108. In the embodiment depicted in FIG. 1, the wavefrontinteractive refractor directs it being 113 of light onto a portion 118of the retina 108. In some embodiments, this beam 113 of light cancomprise a coherent beam of light that can be configured to reflect offthe portion 118 of the retina 108 In some embodiments, the beam 113 canbe configured so as not to damage the retina 108 and/or the portion 118of the retina 108 onto which the beam 113 is directed, and in someembodiments, the theme 113 can comprise a laser.

As seen in FIG. 1, the beam 113 can reflect off the portion 118 of theretina and generate light rays 114, 116 that passed through the lens 106and the cornea 104 and impinge on the wavefront interactive refractor112. In some embodiments, when the light rays 114, 116 pass through thelens 106 and the cornea 104 of the eye 102 the wavefront of the lightrays 114, 116 can be altered according to the optical properties of theeye 102. The light rays 114, 116 can, in some embodiments, impinge on asensor 120 of the wavefront interactive refractor 112. The sensor 120can comprise any desired photodetecting feature, and can, in someembodiments comprise a photodetecting feature that generates and/orcaptures data relating to the refractive state of the eye 102 including,for example, wavefront data which can be used to determine therefractive state of the eye 102. In some embodiments, thephoto-detecting feature can comprise an array of photodetectors and alenslet array spaced from the array of photodetectors and configured tofocus light onto the photodetectors. In some embodiments, thephoto-detecting feature can comprise, for example, a Shack-Hartmannsystem.

In some embodiments, the wavefront interactive refractor 112 cancomprise a patient interface that can include a patient output device122 and a patient input device 124. In some embodiments, the patientoutput device 122 can provide information to the patient and can be, forexample, a display and/or a speaker. In some embodiments, the patientoutput device 122 can provide information to the patient relating to oneor several tasks that the patient can complete. In one embodiment, forexample, the patient output device 122 can comprise a display with animage that is viewable by the patient.

The patient input device 124 can comprise any feature configured toallow the patient to provide an input to the wavefront interactiverefractor 112. In some embodiments, the patient input device 124 cancomprise a button, a key, a keypad, a microphone, or a sensor. Thepatient can, in some embodiments, use the patient input device 124 tocomplete the task which can include, for example, depressing a buttonwhen a specified change in the displayed image occurs.

With reference now to FIG. 2, schematic illustration of one embodimentof a wavefront interactive refractor 112 is shown. Wavefront interactiverefractor 112 includes a processor 200. The processor 200 can provideinstructions to, and receive information from the other components ofthe wavefront interactive refractor 112. The processor 200 can actaccording to stored instructions to control the other components of thewavefront interactive refractor 112. The processor 200 can comprise amicroprocessor, such as a microprocessor from Intel® or Advanced MicroDevices, Inc.®, or the like.

In some embodiments, the processor 200 can be configured to be embeddedin the wavefront interactive refractor 112 and to process full wavefrontreconstructions. In some embodiments, this processor 200 can comprise afield programmable gate array (FPGA).

The wavefront interactive refractor 112 can include user interface 202.The user interface 202 communicates information, including outputs, to,and receives inputs from a user. The user interface 202 can include ascreen, a speaker, a monitor, a keyboard, a microphone, a mouse, atouchpad, a keypad, and/or any other feature or features that canreceive inputs from a user and provide information to a user. In someembodiments, the user interface 202 can provide outputs to, and receiveinputs from a user including a doctor. In some embodiments, the userinterface 202 can be configured to allow the user including the doctorto control the operation of the wavefront interactive refractor 112, andto specifically control the interaction of the wavefront interactiverefractor 112 with the patient.

The wavefront interactive refractor 112 can include a patient interface204. The patient interface 204 communicates information includingoutputs to a patient and receives information including inputs from apatient. In some embodiments, the patient interface 204 can communicateinformation to the patient via a patient visual display. The patientvisual display can provide visual data to the patient. In someembodiments, the patient visual display can be generated by the patientoutput device 122, and specifically in embodiments in which the patientoutput device 122 comprises a display and/or screen, the patient visualdisplay can be shown to the patient by the display and/or screen In someembodiments, the patient interface 204 can be configured to provide apatient with a task and, in some embodiments, to receive inputscorresponding to the patient completion of the task. The patientinterface 204 can comprise a screen, a speaker, a button, monitor, akeyboard, a microphone, a mouse, a touchpad, a keypad, and/or any otherfeature or features that can receive patient inputs and provideinformation to the patient.

The wavefront interactive refractor 112 can comprise communicationengine 206. The communication engine 206 can allow the wavefrontinteractive refractor 112 to communicatingly connect with other devices,and can allow the wavefront interactive refractor 112 to send andreceive information from other devices. The communication engine 206 caninclude features configured to send and receive information, including,for example, an antenna, a modem, a transmitter, receiver, or any otherfeature that can send and receive information. The communication engine206 can communicate via telephone, cable, fiber-optic, or any otherwired communication network. In some embodiments, the communicationengine 206 can communicate via cellular networks, WLAN networks, or anyother wireless network.

The wavefront interactive refractor 112 includes a scanning engine 208.In some embodiments, for example, the scanning engine 208 can beconfigured to generate data corresponding to the refraction state of thepatient's eye 102. In some embodiments, for example, the scanning engine208 can be configured to generate the beam 113, and to direct the beam113 onto the retina 108 of the patient's eye 102. In some embodiments,the scanning engine 208 can be further configured to capture the lightrays 114, 116 reflecting off the retina 108 of the patient's eye 102 andpassing through the lens 106 and the cornea 104 of the patient's eye102. In some embodiments, the scanning engine 208 can be configured togenerate data corresponding to the wavefront of the light rays 114, 116and/or of the light passing through the patient's eye 102, which datacan be used to determine the refractive state of the patient's eye 102.

In some embodiments, the scanning engine 208 can comprise a camera andcan be configured to capture image data of the eye 102. In someembodiments, image data for one or several images captured by thescanning engine 208 can be stored and used to generate a full wavefrontreconstruction of the eye 102.

In some embodiments, the scanning engine 208 can include featuresconfigured to perform wavefront analysis on the eye 102, which featurescan include a wavefront sensor. In one embodiment, the wavefront sensorcan be an optical capture device which can be any device with lightsensing components and can be, for example, a camera and/or scanner. Thewavefront sensor can comprise a plurality of photoreceptors which canbe, for example, arranged into a matrix of photoreceptors. The wavefrontsensor can further comprise an array of lenslets, mirrors, and/or anyother features capable of reflecting and/or refracting light. In oneembodiment, each lenslet and/or mirror can be associated with the subsetof photoreceptors from the matrix of photoreceptors. In one embodiment,for example, each of the lenslets and/or mirrors can be associated witha group of four photoreceptors. In one embodiment, for example, thewavefront sensor can comprise a Hartmann-Shack system.

The wavefront interactive refractor 112 can include memory 210. Thememory 210 can include stored instructions that, when executed by theprocessor 200, control the operation of the wavefront interactiverefractor 112. The details of the memory 210 are discussed at greaterlength below.

As seen in FIG. 2, the memory 210 can include one or several databasesincluding, for example, a task database 212 and a scan database 214. Thetask database 212 can include one or several tasks that can be providedto the patient. In some embodiments, the one or several tasks can beused to affect a refractive state of the patient's eye 102. It isbelieved that a task can serve to distract the patient, whichdistraction can result in relaxation of the ciliary muscles which canreduce and/or eliminate accommodation in the eye 102. This relaxedaccomodative state can allow a more accurate capture of the refractivestate of the eye 102. The task can comprise an instruction explaining tothe patient what the task is and how to complete the task, a stimuluswhich can include, for example, any item, image, or thing that isexperienced by the patient including, for example, a video, a textstring, a question, and/or an input which can be any requested patientaction including, for example, applying force to an object and providingan input to the wavefront interactive refractor 112.

In some embodiments, the task database 212 can comprise an index oftasks included in the task database. This index can include, forexample, data corresponding to the instruction, the stimulus, and/ordesired inputs, and/or user instructions to allow the user to facilitatethe completion of the task by the patient.

The scan database 214 can comprise information generated by the scanningengine 208 and/or data related to information generated by the scanningengine 208. In some embodiments, for example, the information generatedby the scanning engine 208 can include information identifying therefractive state of the eye 102, information tracking the refractivestate of the eye 102 as a function of time, information identifyingturning points including, for example, maximums and minimums, and/orinflection points in the data tracking the refractive state of the eye102 as a function of time, task, and/or pupil size. In some embodiments,the scan database 214 can further include information relating to apatient including, for example, information identifying the patient,information associating a patient with information generated by thescanning engine 208, information associating a patient with previouslygathered information relating to the refractive state of the eye, and/orany other desired patient information.

With reference now to FIG. 3 a schematic illustration of one embodimentof the patient visual display 300 of the wavefront interactive refractor112 is shown. The patient visual display 300 can, as discussed above beprovided by the patient interface engine 204, and particularly by thepatient output device 122. The patient visual display 300 can comprise atarget 302. The target can be an image or object. In some embodiments,the target can be manipulated and/or changed to facilitate changes inthe, date of state of the patient's eye 102 and/or to facilitate therelaxation of the patient and the fully relaxed state of the patient'seye 102. In one embodiment, for example, the target 302 can be displayedto the patient in focus, and then can be moved to an out of focus,fogged position. In some embodiments, the speed and/or the amount ofmotion of to target 302 can be controlled by the user to affect a changein the refractive state of the patient's eye 102.

The target can be changed in a variety of ways to stimulate relaxationof the eye 102 and to facilitate in generating data relating to therefractive state of the eye 102. In some embodiments, the target 302 canbe moved laterally with respect to the patient's eye 102 and in someembodiments, the target 302 can be moved relatively closer to and/orrelatively further from the patient's eye 102. In some embodiments, thevisual distance to the target 302 can be changed. This can beaccomplished by manipulating the wavefront of the target 302 from afirst wavefront to a second wavefront, which first wavefront mimics thewavefront of an object located at a first distance from the patient'seye 102 and the second wavefront mimics the wavefront of an objectlocated at a second distance from the patient's eye 102.

In some embodiments, the target 302 can be adjustable so as to have adifferent size, shape, and/or color. In some embodiments, thebrightness, contrast, and/or focus of the target 302 can be changed. Insome embodiments, the target 302 can be changed from a first image to asecond, and in some embodiments, the image of the target 302 can bechanged as many times as desired.

The target 302 can be any desired image and/or object and/or any desiredtype of image and/or type of object. In some embodiments, the target 302can comprise a point of light having any desired shape. In someembodiments, the target 302 can comprise, for example, a crosshair asdepicted in FIG. 3, a landscape, a string, video images, an animation,or any other image. In some embodiments, the target type may be variedto facilitate relaxation of the accommodation of the eye 102 and tofacilitate the generation of data relating to the refractive state ofthe eye 102. In some embodiments, for example, the manipulation and/orchange of the target 302 can relate to the patient task.

As seen in FIG. 3, the patient visual display 300 comprises a taskindicator 304. In some embodiments, the task indicator 304 can providethe patient information relating to past, current, and/or future tasks.In some embodiments, the task indicator 304 can provide the instructiontelling the patient how to perform the task. As seen in FIG. 3, the taskindicator 304 can comprise a text string.

Patient visual display 300 can, in some embodiments, provide anindicator 306 of the refractive state of the patient's eye 102. In someembodiments, for example, the indicator 306 of the refractive state ofthe patient's eye 102 can provide an indication of the absoluterefractive state of the patient's eye 102 and/or of the relativerefractive state of the patient's eye 102. In some embodiments, forexample, the indicator 306 of the refractive state of the patient's eye102 can provide information regarding the refractive state of thepatient's eye 102 versus time, the refractive state of the patient's eye102 versus task, the refractive state of the patient's eye 102 versuspupil size, and/or the refradctive state of the patient's eye 102 versusany other desired and changing parameter.

In some embodiments, the indicator 306 can further comprise an indicatorof the size of the pupil of the patient's eye 102 that can be separatefrom the indicator 306 of the refractive state of the patient's eye 102and/or integral in the indicator 306 of the refractive state of thepatient's eye 102. In some embodiments, for example, this indicator ofthe pupil size can comprise a plot of pupil size versus time, and insome embodiments, the indicator of the pupil size can comprise a colorscheme of the indicator 306 of the refractive state of the patient's eye102. Thus, in some embodiments, the indicator 306 of the refractivestate of the patient's eye 102 can comprise a first color when the pupilis an undesireable size, and a second color when the pupil is adesireable color. In some embodiments, for example, the color scheme canfurther comprise a third color indicative of the occurrence of a desiredchange in the pupil size, and a fourth color indicative of theoccurrence of an undesired change in the pupil size.

In the embodiment depicted in FIG. 3, the indicator 306 of therefractive state of the patient's eye 102 comprises a status indicator308 and a goal indicator 310. The status indicator 308 can provide thecurrent refractive state of the patient's eye 102. In some embodiments,for example, the current refractive state of the patient's eye 102includes the refractive state of the patient's eye 102 measured with inthe past 200 ms, past 100 ms, the past 50 ms, the past 30 ms, and/or thepast 10 ms. In some embodiments, for example, the current refractivestate of the patient's eye 102 can include the refractive state of thepatient's eye 102 as measured in between the past 200 ms and the past 30ms.

The fluctuations in the focus of the eye are known to be divided intotwo different frequency regimes. These are the low frequency component(LFC) and the high frequency component (HFC). The low frequencycomponent occurs at rates of about 5 hertz or slower and can be thoughtof as being the change in focus that occurs when a person is observing avisual field under conscious control or awareness. The low frequencychanges can vary from far to near focus through the entire range offocus that the eye can achieve. The high frequency component occurs at afaster rate of about 10 hertz or faster and it is associated with smallchanges in focus. This is also sometimes called focus tremor. The focustremor is automatic and unconscious. It is thought that thesemicro-fluctuations are used by the eye to assist the nervous system inachieving a desired focus on a target. It has been reported in theliterature that when the eye has approached the extreme ends of itsfocus range, either the most near or the most far focus, that theamplitude of the HFC becomes diminished. Thus a reduction in HFC can beseen as an indicator of when an eye has reached its most fully relaxedstate. So it would be useful for a doctor to be able to view anindicator showing the strength of the HFC. The speed of the HFC canexceed the rate at which a standard computer software will update adisplay. So it would be beneficial for the software to collect andanalyze high speed data, taken for instance at 30 hertz, and thendisplay at a slower rate an indication of the amplitude of the microfluctuations during a prescribed time period, for instance over 0.2seconds. Such an metric may simply be the difference between the maximumand minimum values of the spherical equivalent seen during the timeperiod. More sophisticated metrics, such as a root mean square value maybe useful as well,

In some embodiments of the wavefront interactive refractor 112, thestatus indicator 308 can be continually updated to reflect the currentrefractive state of the patient's eye 102 during the time period inwhich the scanning engine 208 collects data relating to the refractivestate of the patient's eye 102. Thus, the status indicator 308 can,during operation of the scanning engine 208, continually adjust upwarddown as the refractive state of the patient's eye 102 changes. In oneparticular embodiment, for example, a more hyperopic refraction canresult in the status indicator 308 becoming taller and/or larger, and aless hyperopic refraction can result in the status indicator 308becoming shorter and/or smaller. In some embodiments, the statusindicator 308 can indicate and/or identify a time for capturing dataindicating the refractive state of the patient's eye 102 when the statusindicator 308 reaches and/or surpasses the goal indicator 310.

The goal indicator 310 can comprise a visual indication of a minimumdesired refractive state to be achieved before capturing the refractivestate of the eye 102. In some embodiments, the goal indicator 310 can bea specific goal indicator, and in some embodiments, the goal indicator310 can be a general goal indicator. In embodiments in which the goalindicator 310 is a general goal indicator, the goal indicator canrepresent a value that is nonspecific to the patient and can, forexample, represent an average refractive state of eyes in a populationthat can, for example, the defined by age, gender, race, health, or anyother desired parameter. In some embodiments, the goal indicator 310 cancomprise a threshold value associated with the treatment procedure. Insome embodiments in which the goal indicator 310 is a specific goalparameter, the goal indicator 310 can be generated based on an aspect ofthe patient data. In some embodiments, this can include the mostdesirable refractive state of the patient's eye exhibited over thecourse of evaluation of the patient's eye 102 with the wavefrontinteractive refractor 112, the refractive state of the patient's eye 102that was measured during another and/or previous test such as, themanifest refraction, and/or the refractive state of the patient's eye102 that was collected during the performance of a specific task. Thegoal indicator 310 can comprise any feature and/or image that allows thepatient and/or user to ascertain whether the current refractive state ofthe patient's eye 102 is more or less desirable than the thresholdand/or level indicated by the goal indicator 310.

With reference now to FIG. 4, a schematic illustration of one embodimentof the user visual display 400 of the wavefront interactive refractor112 is shown. The user visual display 400 can provide information invisual format to the user of the wavefront interactive refractor 112. Insome embodiments, the user visual display 400 can comprise a componentof the user interface 202.

As seen in FIG. 4, the user visual display 400 comprises an alignmentindicator 402. In some embodiments, for example, the alignment indicator402 can be configured to facilitate in aligning patient's eye 102 withthe wavefront interactive refractor 112. In some embodiments, forexample, the alignment indicator 402 can be configured to display animage of the patient's eye 112 and an indicator of the alignment of thepatient's eye 112 relative to the wavefront interactive refractor 112and/or the target 302. In some embodiments, for example, the alignmentindicator 402 can display the target 302 overlaid on top of thepatient's eye 112 to thereby allow patient's eye 112 to be positioned inthe desired alignment with respect to the wavefront interactiverefractor 112. As seen in FIG. 4, in one embodiment, the patient's eye102 can be aligned with the wavefront interactive refractor 112 so thatthe target is centered over the pupil 404 of the patient's eye 102.

As also seen in FIG. 4, the user visual display 400 can comprise aindicator 306 of the refractive status of the patient's eye 102including, the status indicator 308 and the goal indicator 310. In someembodiments, and as seen in FIG. 4, the indicator 306 can displaychanges to the refractive state of the patient's eye 102 in terms ofspherical equivalent of the patient's eye 102.

In some embodiments, the user visual display 400 can comprise a button408 that allows the user to provide to request the capture of therefractive state of the patient's eye 102. In some embodiments, thebutton 408 can be a selectable icon located within the user visualdisplay 400, and in some embodiments, the button 408 can comprise anyother feature configured to provide an input to the wavefrontinteractive refractor 112. In some embodiments, a feature of the buttoncan change to identify a time for capturing refractive state data forthe patient's eye 102. In some embodiments, for example, these changescan include a change in the size, color, shape, illumination, and/orappearance of the button 408. In some embodiments, for example, thebutton can be a first color, such as, for example, yellow whenrefractive state data is first collected, which color can indicate thatthere is insufficient data to provide trend information relating to therefractive state of the eye 102. In some embodiments, a desired trend inthe refractive state data can be indicated by a second color, such as,for example, green, of the button 408, and an undesired trend in therefractive state data can be indicated by a third color such as, forexample, red, of the button 408.

With reference now to FIGS. 5A-5D, different embodiments of theindicator 306 are shown. Although the indicators 306 depicted in FIGS.5A-5D comprise visual indicators, in some embodiments, the indicator 306can comprise a non-visual indicator such as, for example, an audiblesignal comprising a changing tone, pitch, and/or volume based on therefractive state of the patient's eye 102 and/or the size of the pupilof the patient's eye.

As seen in FIG. 5A, the indicator 306-A comprises a radial typeindicator. The indicator 306-A includes a status indicator 308-A thatradially extends from the center of the indicator 306-A. The indicator306-A further includes a goal indicator 310-A located a distance fromthe zero indicator 500. In the embodiment depicted in FIG. 5A, thestatus indicator 308-A is located between the zero indicator 500 and thegoal indicator 310-A, thereby indicating that the threshold of the goalindicator 310-A is not currently reached.

With reference now to FIG. 5B, a color indicator 306-B is shown. In theembodiment shown in FIG. 5B, the color indicator 306-B includes thepupil size indicator 502 and refractive state indicator 504. In someembodiments, for example, the size of the pupil can be an importantconsideration in determining the refractive state of the eye 102 anddetermining whether the patient is suited for certain treatmentprocedures. Thus, in some embodiments it can be advantageous to includean indicator of the pupil size in the user visual display 400. In suchan embodiment, the measured pupil size of the patient's eye can becompared to the threshold pupil size demarking between acceptable sizesand unacceptable sizes. In some embodiments in which the pupil size isacceptable, the pupil indicator 502 can display a first color indicativeof the acceptability of the pupil size. In contrast, if the pupil sizeis unacceptable, the people indicator 502 can display a second colorindicative of the acceptability of the pupil size. Similarly, in someembodiments if the pupil size changes to become more acceptable and/orcloser to being acceptable, the pupil indicator 502 can display a firstcolor and if the pupil size changes so that the pupil is less acceptablysized, the pupil indicator 502 can display a second color. In someembodiments, for example, the pupil size can be acceptable when thepupil is less than or equal to 6 mm, and the pupil size can beunacceptable when the pupil is greater than or equal to 6 mm.

The embodiment depicted in FIG. 5B further includes a status indicator308-B. In some embodiments, the status indicator 308-B of the indicator306-B can provide a color based visual signal of the direction of changeand/or acceptability of the refractive status of the patient's eye 102.Thus, in some embodiments, the status indicator 308-B can display afirst color when the refractive state of the patient's eye 102 isdesirable and/or is becoming more desirable, and the status indicator308-B can display a second color when the refractive state of thepatient's eye 102 is undesirable and/or is becoming more undesirable. Insome embodiments, the color scheme comprising multiple colors can beused to indicate the different degrees of desireability and/orundesirable of the refractive state of the patient's eye 102.

FIG. 5C depicts one embodiment of an indicator 306-C in which therefractive status of the eye 102 is plotted as a function of time. Insome embodiments, the refractive status of the eye 102 can be plotted asa function of, for example, task target characteristic, or diagnosisactivity. This format of the indicator 306-C advantageously allows theuser and/or the patient to view trends in the refractive status of thepatient's eye 102 and/or identify tasks and/or situations resulting in amore desirable refractive state of the patient's eye 102. As seen inFIG. 5C, the indicator 306-C includes the status indicator 308-C and thegoal indicator 310-C. In some embodiments, the wavefront interactiverefractor 112 can calculate turning points in the data represented bythe status indicator 308-C, which turning points can be used to betteridentify activities and/or events causing a positive effect on therefractive status of the eye 102 and activities and/or events causing anegative effect on the refractive status of the eye 102.

FIG. 5D depicts one embodiment of an indicator 306-D, which indicator306-D is similar to the indicator 306 discussed in connection with FIGS.3 and 4 above. As discussed in those figures, the indicator 306-Dincludes status indicator 308-D the that moves up and down as the statusof the eye 102 changes, and the goal indicator 310-D that allowsdetermination of whether the refractive status of the eye 102 hasreached the desired goal status or the eye 102.

With reference now to FIG. 6, a flowchart illustrating one embodiment ofa process 600 for identifying a time for capturing the refractive stateof an eye 102 is shown. The process 600 can be performed by thewavefront interactive refractor 112, and/or a component of the wavefrontinteractive refractor 112. The process 600 involves the collection ofdata indicative of a refractive state of the eye, the calculation of therefractive state of the eye 102 using the collected data, and displayingan indicator of the refractive state of the eye 102, and, if it isdetermined to capture data indicative of the refractive state of the eye102, capturing data indicative of the ice refractive state. The process600 begins at block 602 wherein the data indicative of the refractivestate of the eye 102 is collected. In some embodiments, for example,this data can be collected by the scanning engine 208. In someembodiments, this data indicative of the refractive suit the patient'seye 102 can be collected by measuring a wavefront of light passingthrough the patient's eye 102. The details of how this wavefront oflight can be generated are discussed at greater length above withrespect to FIG. 1.

After the data indicative of the refractive state of the eye 102 iscollected, the process 600 proceeds to block 604 wherein the refractivestate of the eye 102 is calculated. In some embodiments, for example,the calculation the refractive state of the eye 102 can includeprocessing the data indicative of the refractive state of the eye 102with a component of the wavefront interactive refractor 112 such as, forexample, the processor 200. In some embodiments, for example, thiscalculation can be based on a full wavefront reconstruction, and in someembodiments this calculation can be performed using the Zernike slopedot-product, which can provide the sphere, cylinder, and axis of thepatient's eye 102.

After the refractive state of the eye 102 is calculated, the process 600proceeds to block 606 wherein an indicator of the refractive state ofthe eye 102 is displayed. In some embodiments, for example, thisindicator of the refractive state of the eye 102 can comprise theindicator 306 discussed at greater length in FIGS. 3, 4, 5 above. Insome embodiments, the indicator 306 can be displayed to the user and/orpatient.

After the indicator of the refractive state of the eye is displayed, theprocess 600 proceeds to decision state 608 wherein it is determinedwhether to capture data indicative of the refractive state of the eye102. In some embodiments, for example, the capture of data indicative ofthe refractive state of the eye 102 can differ from the collection ofdata indicative of the refractive state of the eye 102 in that thecapture data can comprise a definitive measure of the refractive stateof the patient's eye 102. In some additional embodiments, the captureddata indicative of the refractive state of the eye 102 can differ fromthe collected data indicative of the refractive to the eye 102 in thatthe captured data indicative of the refractive state of the eye 102 isstored.

In some embodiments, the wavefront interactive refractor 112 can receivean indication from the user and/or patient to capture data indicative ofthe refractive state of the eye. In some embodiments, for example, thisindication can be provided to the wavefront interactive refractor withbutton 408 or any other feature of the user interface 202 and/or patientinterface 204 configured to initiate capture of the refractive state ofthe patient's eye 102. If it is determined not to capture dataindicative of the refractive student the eye 102, then the process 600can return to block 602 and continue the collection of data indicativeof the refractive state of the eye.

If it is determined to capture data indicative of the refractive stateof the eye 102, then the process 600 proceeds to block 610 wherein dataindicative of the refractive state of the eye 102 is captured. In someembodiments, this capture can proceed in the same manner as outlinedabove with respect to block 602.

In some embodiments, data indicative of the refractive state of the eye102 can be captured immediately after it is determined to capture datarelating to the refractive state of the eye 102, and in someembodiments, a set of data before and/or after it is determined tocapture data relating to the refractive state of the eye 102 can becaptured. In some embodiments, this data can include the refractivestate of the patient's eye 0.5 seconds, 1 second, 2 seconds, 3 seconds,4 seconds, 5 seconds, 10 seconds, and/or any other or intermediate timebefore and/or after it is determined whether to capture data relating tothe refractive state of the eye 102. In some embodiments, this data canbe analyzed to determine the most desired refractive state of the eye102 in the captured data.

In some embodiments, in contrast to the collection of data indicative ofthe refractive state of the eye 102, the scanning engine 208 can beconfigured to operate at a higher resolution and/or with greateraccuracy when capturing data indicative of the refractive state of theeye 102 than when collecting data indicative of the refractive state ofthe eye as discussed to block 602.

In some embodiments, for example, the lower resolution of the datagathered by the scanning engine 208 during the collection of dataindicative of the refractive state of the eye 102 can facilitateaccelerating the calculation of the refractive state of the eye tothereby more quickly update the indicator 306 with data reflecting thecurrent refractive state of the eye 102.

In some embodiments, the data indicative of the refractive state of theeye 102 captured in block 610 can be stored in the memory 210 of thewavefront interactive refractor 112 including, for example, in the scandatabase 214 of the memory 210 of the wavefront interactive refractor112. In some embodiments, for example, this captured data can beassociated with the patient, the patient's eye, the user, the timeand/or date that the data was captured, and/or any other desiredinformation.

After the data indicative of the refractive state of the eye iscaptured, the process 600 proceeds to block 612 wherein the refractivestate of the eye 102 is calculated. In some embodiments, thiscalculation can be performed in the same manner as described withrespect to block 604, but in embodiments in which the resolution and/oraccuracy of the captured data indicative of the refractive state of theeye is greater than the resolution and/or accuracy of the collected dataindicative of the refractive state of the eye 102, this calculation canlikewise provide more accurate and better resolution in the calculationresults.

In some embodiments, for example, the calculation the refractive stateof the eye can include processing the data indicative of the refractivestate of the eye with a component of the wavefront interactive refractor112 such as, for example, the processor 200. In some embodiments, forexample, this calculation can be based on a full wavefrontreconstruction, and in some embodiments this calculation can beperformed using the Zernike slope dot-product, which can provide thesphere, cylinder, and axis of the patient's eye 102. Is calculatedrefractive the state of the eye can be stored in the memory 210 of thewavefront interactive refractor 112 including, for example, in the scandatabase 214 of the memory 210 of the wavefront interactive refractor112. In some embodiments, for example, this capture data can beassociated with the patient, the patient's eye, the user, the timeand/or date that the data was captured, and/or any other desiredinformation.

After the refractive state of the eye 102 is calculated, the processproceeds to block 614 wherein an indicator of the refractive state ofthe eye 102 is provided. In some embodiments this indicator can beprovided via the user and/or patient interface 202, 204 or via thecommunication engine 206 to another device.

With reference now to FIG. 7, flowchart illustrating another embodimentof a process for identifying a time for capturing the refractive stateof an eye is shown. The process 700 can be performed by the wavefrontinteractive refractor 112, and/or a component of the wavefrontinteractive refractor 112. The process 700 involves the collection ofdata indicative of a refractive state of the eye, and using that data tocalculate the refractive state of the patient's eye 102, to provide anindicator of the refractive state of the patient's eye 102, and toidentify a time at which to capture data indicative of the refractivestate of the patient's eye 102. The process 700 begins at block 702wherein a request for refractive state data collection is received. Insome embodiments, for example, this request can be provided by a patientand/or user and can be received by the user interface 202, the patientinterface 204, and/or the communication engine 206.

After the request for refractive state data collection has beenreceived, the process 700 proceeds to block 704 wherein the collectingof data indicative of the refractive state of the eye 102 is started. Insome embodiments, for example, the collection of data indicative of therefractive state of the eye 102 can be continuously performed until theprocess 700 terminates and/or until an input is received requesting theending of the collection of that data.

In some embodiments, for example, this data can be collected by thescanning engine 208. In some embodiments, this data indicative of therefractive state of the patient's eye 102 can be collected by measuringa wavefront of light passing through the patient's eye 102. The detailsof how this wavefront of light can be generated are discussed at greaterlength above with respect to FIG. 1.

After the collecting of data indicative of the refractive state of theeye 102 is started, the process 700 proceeds to block 706 wherein thecalculation of the refractive state of the eye 102 is started. Inembodiments in which data indicative of the refractive state of the eye102 is continuously and/or repeatedly collected, the refractive state ofthe eye 102 can likewise be continuously and/or repeatedly calculated.Advantageously, this continuous and/or repeated calculation of therefractive state of the eye 102 can allow display of more accurateinformation relating to the current refractive state of the eye 102.

In some embodiments, for example, the calculation of the refractivestate of the eye 102 can include processing the data indicative of therefractive state of the eye with a component of the wavefrontinteractive refractor 112 such as, for example, the processor 200. Insome embodiments, for example, this calculation can be based on a fullwavefront reconstruction, and in some embodiments this calculation canbe performed using the Zernike slope dot-product, which can provide thesphere, cylinder, and axis of the patient's eye 102.

After the calculating of the refractive state of the eye 102 is started,the process 700 proceeds to block 708 wherein an indicator of thewavefront interactive refractor alignment is provided. In someembodiments, for example, this indicator of the wavefront interactiverefractor alignment can comprise the alignment indicator 402 depicted inFIG. 4. In some embodiments, the indicator of the alignment of thewavefront interactive refractor 112 can facilitate in determiningwhether the patient's eye 102 is properly aligned so as to allowgeneration of accurate data reflecting the refractive state of thepatient's eye 102. In some embodiments, the wavefront interactiverefractor 112 can comprise features configured to allow the patientand/or user to affect the alignment of the eye 102 relative to thewavefront interactive refractor 112. In some embodiments, for example,these features can allow the repositioning of the eye 102 relative tothe wavefront interactive refractor 112 so as to properly aligned theeye 102. In some embodiments, for example, the alignment of the eye 102with respect to the wavefront interactive refractor 112 can result inthe relaxation of the accommodation of the eye 102, which relaxation caninfluence the refractive state of the eye. In some embodiments, anychange in the accommodative state of the eye 102 occurring during thealignment of the wavefront interactive refractor 112 with eye 102 can beindicated in the collected data indicative of the refractive state ofthe eye 102. In some embodiments, for example, aspects of the aligningof the wavefront interactive refractor 112 with the eye 102 can bemanipulated to affect a desired change in the refractive state of theeye. Thus, in some embodiments, aspects of the aligning of the wavefrontinteractive refractor 112 with the eye 102 can be performed for thepurpose of determining their effect on the refractive state of the eye102, and in some embodiments, can be performed for the purpose ofcreating an capturing a desired refractive state of the eye 102.

After the indicator of the alignment of the wavefront interactiverefractor 112 has been provided, the process 700 proceeds to block 710wherein an indicator of the refractive state of the eye 102 is provided.In some embodiments, for example, this indicator of the refractive stateof the eye 102 can comprise the indicator 306 discussed at greaterlength in FIGS. 3, 4, 5 above. In some embodiments, the indicator 306can be displayed to the user and/or patient. In some embodiments, thethis indicator 306 can be updated as new calculations of the refractivestate of the patient's eye 102 are completed and/or performed. In someembodiments, for example, the indicator of the refractive state of theeye 102 can be continuously provided during process 700 so as to provideinformation on any changes in the refractive state of the eye 102.

After an indicator of the refractive state of the eye 102 is provided,the process proceeds to block 712 wherein a task request is received. Insome embodiments, for example, the patient and/or user can request atask to facilitate the achievement of the desired refractive state ofthe eye 102. In some embodiments, this task can be configured to providethe patient with a distraction so as to encourage relaxation of theaccommodation of the eye 102. In some embodiments, the task request canbe received by the user interface 202, the patient interface 204, and/orthe communication engine 206.

After the task request is received, the process 700 proceeds to block714 wherein an indicator of the task is provided. In some embodiments,for example, the indicator of the task can comprise a task indicator 304discussed at length above. In some embodiments, the indicator of thetask can be configured to provide information to the patient and/or userrelating to the task and how to complete the task. In some embodiments,the indicator of the task can be displayed to the patient via thepatient visual display 300 and/or to the user via the user visualdisplay 400.

After the indicator of the task is provided, the process 700 proceeds toblock 716 wherein a task input is received. In some embodiments, thetask input can comprise an indicator of the performance and/orcompletion of the task by the patient and/or user. In some embodiments,for example, the task input can be provided to the wavefront interactiverefractor 112 via, for example, the user interface 202 and/or thepatient interface 204. In some embodiments, for example, the task inputcan be provided by the patient input device 124.

After the task input has been received, the process proceeds to decisionstate 718 wherein it is determined if there is an additional task. Insome embodiments, this determination can include querying the taskdatabase 212 to determine whether all of the tasks have been provided tothe patient and/or user. If it is determined that there are additionaltasks, then the process can return to block 712. If it is determinedthat there are no additional tasks, or at any other point in process700, the wavefront interactive refractor 112 can receive a request tocapture data indicative of the refractive state of the eye 102. Thisrequest can be provided by the patient and/or user to the wavefrontinteractive refractor 112 via the user interface 202, the patientinterface 204, and/or the communication engine 206.

After the request to capture data indicative of the refractive state ofthe eye 102 is received, the process 700 proceeds to block 722 whereindata indicative of the refractive state of the eye 102 is captured. Insome embodiments, this capture can proceed in the same manner asoutlined above with respect to block 704. In some embodiments, incontrast to the collection of data indicative of the refractive state ofthe eye 102, the scanning engine 208 can be configured to operate at ahigher resolution and/or with greater accuracy when capturing dataindicative of the refractive state of the eye 102 than when collectingdata indicative of the refractive state of the eye 102 as discussed inblock 704. In some embodiments, for example, the lower resolution of thedata gathered by the scanning engine 208 during the collection of dataindicative of the refractive state of the eye 102 can facilitatedecreasing the time required for the calculation of the refractive stateof the eye 102 which can thereby allow faster updates of the indicator306 with data reflecting the current refractive state of the eye 102.

In some embodiments, the data indicative of the refractive state of theeye 102 captured in block 722 can be stored in the memory 210 of thewavefront interactive refractor 112 including, for example, in the scandatabase 214 of the memory 210 of the wavefront interactive refractor112. In some embodiments, for example, this captured data can beassociated with the patient, the patient's eye 102, the user, the timeand/or date that the data was captured, and/or any other desiredinformation.

After the data indicative of the refractive state of the eye 102 iscaptured, the process 700 proceeds to block 724 wherein the refractivestate of the eye 102 is calculated. In some embodiments, thiscalculation can be performed in the same manner as described withrespect to block 706, but in embodiments in which the resolution and/oraccuracy of the captured data indicative of the refractive state of theeye 102 is greater than the resolution and/or accuracy of the collecteddata indicative of the refractive state of the eye 102, this calculationcan likewise provide more accurate and better resolution in thecalculation results.

In some embodiments, for example, the calculation the refractive stateof the eye can include processing the data indicative of the refractivestate of the eye with a component of the wavefront interactive refractor112 such as, for example, the processor 200. In some embodiments, forexample, this calculation can be based on a full wavefrontreconstruction, and in some embodiments this calculation can beperformed using the Zernike slope dot-product, which can provide thesphere, cylinder, and axis of the patient's eye 102. Is calculatedrefractive the state of the eye can be stored in the memory 210 of thewavefront interactive refractor 112 including, for example, in the scandatabase 214 of the memory 210 of the wavefront interactive refractor112. In some embodiments, for example, this captured data can beassociated with the patient, the patient's eye 102, the user, the timeand/or date that the data was captured, and/or any other desiredinformation.

After the refractive state of the eye 102 is calculated, the process 700proceeds to block 726 wherein an indicator of the refractive state ofthe eye 102 is provided. In some embodiments this indicator can beprovided via the user and/or patient interface 202, 204 or via thecommunication engine 206 to another device.

With reference now to FIG. 8, a flowchart illustrating one embodiment ofa process 800 for identifying a patient task resulting in a desiredrefractive state of the eye 102 is shown. In some embodiments, and asdiscussed above, the performance of different tasks by the patient canresult in different refractive states of the patient's eye 102. In someembodiments, some or all of these refractive states may achieve desiredlevels, and in some embodiments, some or all of these refractive statesmay not achieve desired levels. Thus, the determination of the taskassociated with an achieved refractive state of the eye 102 canadvantageously allow the performance of the task resulting in a desiredrefractive state of the eye, and capturing data relating to thisrefractive state of the eye 102.

The process 800 begins at block 802 wherein the steps discussed inblocks 702 through 710 of FIG. 7 are performed. After the stepsdiscussed in blocks 702 through 710 of FIG. 7 have been performed, theprocess 800 proceeds to block 804 wherein a task request is received. Insome embodiments, for example, the patient and/or user can request atask to facilitate the achievement of the desired refractive state ofthe eye 102. In some embodiments, this task can be configured to providethe patient with the distraction so as to encourage relaxation of theaccommodation of the eye. In some embodiments, the task request can bereceived by the user interface 202, the patient interface 204, and/orthe communication engine 206.

After the task request is received, the process 800 proceeds to block806 wherein an indicator of the task is provided. In some embodiments,for example, the indicator of the task can comprise a task indicator 304discussed at length above. In some embodiments, the indicator of thetask can be configured to provide information to the patient and/or userrelating to the task and how to complete the task. In some embodiments,the indicator of the task can be displayed to the patient via thepatient visual display 300 and/or to the user via the user visualdisplay 400.

After the indicator of the task is provided, the process 800 proceeds toblock 808 wherein a task input is received. In some embodiments, thetask input can comprise an indicator of the performance and/orcompletion of the task by the patient and/or user. In some embodiments,for example, the task input can be provided to the wavefront interactiverefractor 112 via, for example, the user interface 202 and/or thepatient interface 204. In some embodiments, for example, the task inputcan be provided by the patient input device 124.

After the task input has been received, the process 800 proceeds todecision state 810 wherein it is determined if there is an additionaltask. In some embodiments, this determination can include querying thetest database 212 to determine whether all of the tasks have beenprovided to the patient and/or user. If it is determined that there areadditional tasks, then the process can return to block 804.

If it is determined that there are no additional task, then the process800 can proceed to block 812 and aggregate the collected data indicativeof the refractive state of the eye 102. In some embodiments, forexample, the aggregation of the collected data indicative of therefractive state of the eye 102 can include ending the collection ofdata indicative of the refractive state the eye 102, and in someembodiments the collection of data indicative of the refractive state ofthe eye 102 can continue during the aggregation of the collected dataindicative of the refractive state of the eye 102. In some embodiments,for example, in which the collection of data continues after theaggregation of the collected data is started, the aggregation can be,for example, limited to data collected before the start of theaggregation, and in some embodiments, the aggregation may not be limitedto any data set, but may rather update as additional data is received.

In some embodiments, the aggregation of the collected data can beperformed by a component of the wavefront interactive refractor 112 suchas, for example, the processor 200 and/or the memory to 10 including thetest database 212 and/or the scan database 214. In some embodiments, forexample, collected data indicative of the refractive state of the eye102 can be retrieved from the memory 210 including, for example, thetest database 212 and/or the scan database 214.

After the collected data has been aggregated the process 800 proceeds toblock 814 wherein provided task are correlated with the collected data.In some embodiments, this correlation can include providing an indicatorin the time sequence of the refractive state of the patient's eye as tothe perform task was started and/or when the perform task was completed.In some embodiments, this correlation of the provided tasks with thecollected data can further include correlating any detected actionperformed using the wavefront interactive refractor 112 with the timesequence of the refractive state of the patient's eye 102. This caninclude, for example, any change to the alignment of the eye 102 withrespect to the wavefront interactive refractor 112 and/or any non-taskrelated change to the target 302 and/or to the patient visual display300.

After the tasks are correlated to the data, the process 800 proceeds toblock 816 wherein maximums and minimums in the aggregated dataindicative of the refractive state of the eye 102 are identified. Insome embodiments, for example, the identification of the one or severalmaximums and/or minimums can be performed by a component of thewavefront interactive refractor 112 including, for example, theprocessor 200.

After the minimums and/or maximums in the aggregated data indicative ofthe refractive state of the eye 102 are identified, the process 800proceeds to block 818 wherein tasks associated with the minimums andmaximums identified. In some embodiments, for example, this can includedetermining the task associated with the time in which a minimum and/ormaximum was achieved and/or determining the task that is temporally mostproximate to the time at which a minimum and/or maximum was achieved.

In some embodiments, for example, the calculated minimums and/ormaximums associated with the aggregated data indicative of therefractive state of the patient's eye 102 can be compared against thedesired refractive state of the patient's eye 102. In some embodiments,this desired refractive state of the patient's eye

After the tasks associated with the minimums and/or maximums identified,the process proceeds to block 820 wherein an indicator of one or severaltasks associated with the desired refractive state of the eye 102 isprovided. In some embodiments, for example, the identified minimumsand/or maximums can be compared to the desired refractive state of theeye 102. This comparison can allow the identification of tasks resultingin a refractive state of the eye 102 that is most desired, meets thedesired refractive state of the eye 102, and/or comes closest to meetingthe desired refractive state of the eye 102. In some embodiments, thisinformation can be provided to the user and/or patient via, for example,via a component of the user interface 202 such as, for example, the uservisual display 400 and/or via a component of the patient interface 204such as, for example, the patient visual display 300.

In some embodiments, after the tasks associated with minimums and/ormaximums identified, this information can be provided to the testdatabase 212. This information can be used to create a task list in thetask database 212, which task list is specific to the patient and can beused to facilitate the identification of a time for capturing eyerefraction data, and/or for capturing eye refraction data when the eyeis in a desired refractive state. In such an embodiment, the process 800can proceed to block 712 of FIG. 7.

With reference now to FIG. 9, a list 900 of tasks is provided. In someembodiments, and as discussed at greater length above, a task can beprovided to the patient to facilitate in identifying a time forcapturing refractive state data of the eye 102, and to facilitateachieving a desired refractive state of the eye. In some embodiments,these tasks can include, gripping a portion of the wavefront interactiverefractor 112 including, for example, a handle that may include apressure sensor configured to detect when the patient is completing atask, imagining something including, for example, an image, a scene, amemory, and/or a pleasant experience, performing a mental gameincluding, for example, mental mathematics including mental additionand/or subtraction, and/or mental spelling and, in some embodiments,providing the result of the mental game to the wavefront interactiverefractor 112, identifying a change in the target 302 and providing anindication of the change to the wavefront interactive refractor 112,identify words and/or images of real objects from a series of imagesinterspersing real words and/or images of real objects with images ofnonwords and/or of non-real objects, and/or a target game wherein thepatient can manipulate a feature of the target including, for example,changing the target image to achieve the desired outcome. In someembodiments, one or several tasks can be combined into a single task,thus, in one embodiment, for example, the task can comprise readingchanging text and/or clicking a button when a word describes a certaintype of object is read. A person of skill in the art will recognize thatthe list 900 does not include all tasks that could be provided by thewavefront interactive refractor 212, and that tasks include anyactivity, event, and/or action which affects the refractive state of thepatient's eye 102.

With reference now to FIG. 10, a list 1000 of target changes isprovided. As discussed above, in some embodiments the target 302 can bechanged and/or manipulated so as to affect a change in the refractivestate of the patient's eye 102. In some embodiments, these changes canbe associated with the task as discussed above.

The change of the target 302 can be controlled by a component of thewavefront interactive refractor 112 including, for example, theprocessor 200, and in some embodiments, the change the target 302 can becontrolled by the user and/or patient via the user interface 202 and/orthe patient interface 204. The list 1000 of changes to the target 302can include, for example, a change of the target image such as, forexample, changing from a crosshair target 302 to a landscape scenetarget 302, a change of a feature of the target 302, a change of a colorof all or a portion of the target 302. In some embodiments, changing thecolor of the target can simulate motion of the target 302 as differentcolors of light focus at different distances in the eye 102.

As seen in FIG. 10, potential changes to the target 302 can furtherinclude a change in the shape of all or a portion of the shape of thetarget 302, a change in the level of contrast of all or a portion of thetarget 302, a change in the brightness of all or a portion of the target302, a change in both the brightness and the position of the target 302,a change in the brightness and the focus of the target 302. In someembodiments, change in brightness in connection with a change in anotheraspect of the target can advantageously take advantage of changes in therefractive state of the eye 102 that can accompany changes in the pupilsize of the eye. In some embodiments, for example, the brightness of thetarget 302 can be varied to affect the refractive state of the eye 302,and in some embodiments, the brightness of the target 302, as well asother aspects of the target 302 can be changed to affect the refractivestate of the eye 102. In some embodiments, the brightness of the targetcan be automatically adjusted based on the level of focus of and/ordistance from the target 302, and in some embodiments, the user cancontrol the brightness of the target 302.

In some embodiments, for example, as the focus of the target 302decreases and/or as the distance to the target 302 increases, thebrightness of the target 302 can also be increased to affect a change inthe refractive state of the eye 102. As discussed above some pupil sizescan be desired. In such an embodiment, the benefits of increasing thebrightness of the target as measured by the increased relaxation of theaccommodation of the patient's eye can be weighed against the detrimentsof increasing the brightness of the target 302 as measured by thedecreased pupil diameter.

In some embodiments, the effects of the change in pupil size, such ascaused by the change in the brightness of the target 302, can becompensated for in calculating the refractive state of the eye 102.Specifically, for example, the spherical equivalent of the eye 102varies with pupil diameter, which pupil diameter varies with time.Specifically, in some embodiments, the spherical equivalent of the eye102 can get very large when the pupil exceeds diameters of, for example,4 mm, 5 mm, 6 mm or 8 mm. As it may, in some embodiments, beadvantageous for the indicator 306 of the refractive state of the eye102 to display the accomodative state of the eye 102 independent of thesize of the pupil, the calculation of the refractive state of the eye102 can use a corrective aspect to adjust for the varying size of thepupil diameter, especially when the brightness of the target 302 isvaried. In some embodiments, for example, this corrective aspect cancomprise a Seidel correction that includes the spherical aberrationterm, and in some embodiments, the calculation can be based on aparticular analysis diameter, which diameter can be chosen to be thediameter that provides the best match when comparing the measuredrefractive state of the eye 102 with the goal parameter associated withthe goal indicator 310.

As seen in FIG. 10, potential changes to the target 302 can furtherinclude a change in the focus of the target 302, and/or a target 302comprising video that can include, for example, a object movingadvancing from the distance, or receding into the distance, such as, forexample, a ball receding into the distance. In some embodiments, forexample, multiple changes to the target 302 can occur at once.

A number of variations and modifications of the disclosed embodimentscan also be used. Specific details are given in the above description toprovide a thorough understanding of the embodiments. However, it isunderstood that the embodiments may be practiced without these specificdetails. For example, well-known circuits, processes, algorithms,structures, and techniques may be shown without unnecessary detail inorder to avoid obscuring the embodiments.

Implementation of the techniques, blocks, steps and means describedabove may be done in various ways. For example, these techniques,blocks, steps and means may be implemented in hardware, software, or acombination thereof. For a hardware implementation, the processing unitsmay be implemented within one or more application specific integratedcircuits (ASICs), digital signal processors (DSPs), digital signalprocessing devices (DSPDs), programmable logic devices (PLDs), fieldprogrammable gate arrays (FPGAs), processors, controllers,micro-controllers, microprocessors, other electronic units designed toperform the functions described above, and/or a combination thereof.

Also, it is noted that the embodiments may be described as a processwhich is depicted as a flowchart, a flow diagram, a swim diagram, a dataflow diagram, a structure diagram, or a block diagram. Although adepiction may describe the operations as a sequential process, many ofthe operations can be performed in parallel or concurrently. Inaddition, the order of the operations may be re-arranged. A process isterminated when its operations are completed, but could have additionalsteps not included in the figure. A process may correspond to a method,a function, a procedure, a subroutine, a subprogram, etc. When a processcorresponds to a function, its termination corresponds to a return ofthe function to the calling function or the main function.

Furthermore, embodiments may be implemented by hardware, software,scripting languages, firmware, middleware, microcode, hardwaredescription languages, and/or any combination thereof. When implementedin software, firmware, middleware, scripting language, and/or microcode,the program code or code segments to perform the necessary tasks may bestored in a machine readable medium such as a storage medium. A codesegment or machine-executable instruction may represent a procedure, afunction, a subprogram, a program, a routine, a subroutine, a module, asoftware package, a script, a class, or any combination of instructions,data structures, and/or program statements. A code segment may becoupled to another code segment or a hardware circuit by passing and/orreceiving information, data, arguments, parameters, and/or memorycontents. Information, arguments, parameters, data, etc. may be passed,forwarded, or transmitted via any suitable means including memorysharing, message passing, token passing, network transmission, etc.

For a firmware and/or software implementation, the methodologies may beimplemented with modules (e.g., procedures, functions, and so on) thatperform the functions described herein. Any machine-readable mediumtangibly embodying instructions may be used in implementing themethodologies described herein. For example, software codes may bestored in a memory. Memory may be implemented within the processor orexternal to the processor. As used herein the term “memory” refers toany type of long term, short term, volatile, nonvolatile, or otherstorage medium and is not to be limited to any particular type of memoryor number of memories, or type of media upon which memory is stored.

Moreover, as disclosed herein, the term “storage medium” may representone or more memories for storing data, including read only memory (ROM),random access memory (RAM), magnetic RAM, core memory, magnetic diskstorage mediums, optical storage mediums, flash memory devices and/orother machine readable mediums for storing information. The term“machine-readable medium” includes, but is not limited to portable orfixed storage devices, optical storage devices, and/or various otherstorage mediums capable of storing that contain or carry instruction(s)and/or data.

While the principles of the disclosure have been described above inconnection with specific apparatuses and methods, it is to be clearlyunderstood that this description is made only by way of example and notas limitation on the scope of the disclosure.

1-16. (canceled)
 17. A method, comprising: a scanning engine repeatedlycollecting data, at a first resolution, indicative of a refractive stateof a patient's eye over a period of time; repeatedly ascertaining acurrent refractive state of the patient's eye from the repeatedlycollected data indicative of the refractive state of the patient's eye;continuously displaying an indication of the current refractive state ofthe patient's eye, the displayed indication of the current refractivestate being continuously variable with time; while displaying theindication of the current refractive state of the patient's eye,receiving from a user or the patient a command to capture additionaldata indicative of the refractive state of the patient's eye; and inresponse to the command, the scanning engine capturing additional data,at a second resolution, indicative of the refractive state of thepatient's eye, wherein the second resolution is greater than the firstresolution; and ascertaining a final refractive state of the patient'seye from the captured additional data indicative of the refractive stateof the patient's eye.
 18. The method of claim 17, wherein the dataindicative of the refractive state of the patient's eye is wavefrontdata sensed by a Shack-Hartmann wavefront sensor.
 19. The method ofclaim 17, further comprising providing an accommodation aid to thepatient while the scanning engine repeatedly collects, at the firstresolution, data indicative of the refractive state of the patient'seye.
 20. The method of claim 17, further comprising, while displayingthe indication of the current refractive state of the patient's eye:receiving a task request from the user or the patient; and in responseto the received task request, providing an indicator of a first patienttask to be performed by the patient.
 21. The method of claim 20, furthercomprising receiving a patient input in response to the first patienttask to be performed.
 22. The method of claim 20, further comprisingdisplaying to the patient a target with a changing property.
 23. Themethod of claim 22, wherein the indicator of the first patient taskincludes a request for a patient input in response to the changingproperty of the target.
 24. The method of claim 22, wherein the changingproperty includes one of: changing a brightness of at least a portion ofthe target; changing a color of at least a portion of the target;changing a clarity of at least a portion of the target; changing animage of the target; and changing a size of the target.
 25. The methodof claim 20, further comprising: receiving a second task request fromthe user or the patient; and in response to the received second taskrequest, providing an indicator of a second patient task to be performedby the patient, the second patient task being different than the firstpatient task.
 26. The method of claim 17, wherein the final refractivestate of the patient's eye is ascertained with greater accuracy from thecaptured additional data indicative of the refractive state of thepatient's eye than the current refractive state of the patient's eye isascertained from the collected data indicative of the refractive stateof a patient's eye.
 27. A system, comprising: a patient interfaceconfigured to display a target to a patient; a scanning engineconfigured to obtain data indicative of a refractive state of apatient's eye; a display device; and a processor configured to: causethe scanning engine to repeatedly collect data, at a first resolution,indicative of the refractive state of the patient's eye over a period oftime; repeatedly ascertain a current refractive state of the patient'seye from the repeatedly collected data indicative of the refractivestate of the patient's eye; cause the display device to continuouslydisplay an indication of the current refractive state of the patient'seye, the displayed indication of the current refractive state beingcontinuously variable with time; while displaying the indication of thecurrent refractive state of the patient's eye, receive from a user orthe patient a command to capture additional data indicative of therefractive state of the patient's eye; and in response to the command,cause the scanning engine to capture additional data, at a secondresolution, indicative of the refractive state of the patient's eye,wherein the second resolution is greater than the first resolution; andascertain a final refractive state of the patient's eye from thecaptured additional data indicative of the refractive state of thepatient's eye.
 28. The system of claim 27, wherein the display device isincluded in the patient interface.
 29. The system of claim 27, furthercomprising a user interface distinct from the patient interface, whereinthe display device is included in the user interface.
 30. The system ofclaim 27, wherein the processor is configured to receive the command tocapture additional data indicative of the refractive state of thepatient's eye via the patient interface.
 31. The system of claim 27,further comprising a user interface distinct from the patient interface,wherein the processor is configured to receive the command to captureadditional data indicative of the refractive state of the patient's eyevia the user interface.
 32. The system of claim 27, wherein the scanningengine includes a Shack-Hartmann wavefront sensor.
 33. The system ofclaim 27, wherein the processor is further configured to cause thepatient interface to provide an accommodation aid to the patient whilethe scanning engine repeatedly collects, at the first resolution, dataindicative of the refractive state of the patient's eye.
 34. The systemof claim 27, wherein the processor is further configured to, while thedisplay device displays the indication of the current refractive stateof the patient's eye: receive a task request from the user or thepatient; and in response to the received task request, provide anindicator of a patient task to be performed by the patient.
 35. Thesystem of claim 34, wherein the processor is further configured to causethe patient interface to display to the patient the target with achanging property.
 36. The system of claim 35, wherein the indicator ofthe patient task includes a request for a patient input in response tothe changing property of the target.